免疫球蛋白4相关性泪腺炎和泪腺淋巴瘤患者临床特征及免疫学指标差异性分析的临床研究  

The difference of clinical features and immunological indicators of immunoglobulin G4-related dacryoadenitis and lacrimal lymphomas

作　　者：柳睿 王楠 王金锦 孙梅 葛心 马建民 Liu Rui;Wang Nan;Wang Jinjin;Sun Mei;Ge Xin;Ma Jianmin(Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing Ophthalmo-logy and Visual Sciences Key Laboratory,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院,北京同仁眼科中心,北京市眼科学与视觉科学重点实验室,100730

出　　处：《中华眼科医学杂志（电子版）》2021年第4期217-222,共6页Chinese Journal of Ophthalmologic Medicine(Electronic Edition)

基　　金：北京市自然基金项目(7182038);北京市医院管理中心"登峰"计划项目(DFL20190201)。

摘　　要：目的比较免疫球蛋白(Ig)G4相关性泪腺炎和泪腺淋巴瘤患者临床特点及免疫学指标的差异性。方法收集2011年6月至2019年6月于首都医科大学附属北京同仁医院眼科中心诊断为IgG4相关性泪腺炎105例(172只眼)和泪腺淋巴瘤患者39例(46只眼)的临床资料。其中,男性57例(78只眼),女性87例(140只眼);年龄10~89岁,平均年龄(55.3±13.6)岁。记录并统计全部患者的性别、年龄、眼别、既往病史、临床表现、影像学特征及免疫学指标等数据。年龄以x±s表示,组间的比较采用独立样本t检验;性别、眼别、既往病史及临床表现以例和百分比表示,组间比较采用卡方检验和(或)Fisher确切概率法;免疫学指标符合正态分布时以x±s表示,其余以中位数和上下四分位数表示,组间比较采用非参数秩和检验。结果IgG4相关性泪腺炎和泪腺淋巴瘤患者中男女性别比分别为1∶2.75和2.9∶1。IgG4相关性泪腺炎患者中女性占比多于泪腺淋巴瘤者;泪腺淋巴瘤单眼发病数多于IgG4相关性泪腺炎者。两组患者性别与眼别比较的差异均有统计学意义(χ^(2)=27.047,25.486;P<0.05)。IgG4相关性泪腺炎患者中有术前糖皮质激素用药史者、手术史者、哮喘病史者、淋巴结肿大史者、鼻窦炎病史者及免疫系统疾病史者分别为24例、3例、4例、4例、27例及3例,分别占22.9%、2.9%、3.8%、3.8%、25.7%及2.9%。泪腺淋巴瘤患者中,则分别有9例、9例、0例、0例、5例及0例,分别占23.1%、23.1%、0、0、12.8%及0。经Fisher确切概率法检验,两组患者中有既往手术治疗史者比较的差异有统计学意义(P<0.05);有哮喘史、淋巴结肿大史及免疫系统疾病史者比较的差异无统计学意义(P>0.05)。两组患者术前有糖皮质激素用药史和鼻窦炎史者比较的差异无统计学意义(χ^(2)=0.001,2.735;P>0.05)。两组患者主要临床表现为眼睑肿胀,IgG4相关性泪腺炎和泪腺淋巴瘤患者中有眼Objective The aim of this study was to investigate comparatively the clinical characteristics and immunological indicators of immunoglobulin G4(IgG4)-related dacryoadenitis and lacrimal lymphomas.Methods 105 patients(172 eyes)with IgG4-related dacryoadenitis and 39 patients(46 eyes)with lacrimal lymphoma diagnosed by histopathologist in Beijing Tongren Eye Center,Beijing Tongren Hospital affiliated to Capital Medical University from June 2011 to June 2019 were enrolled.There were 57 males(78 eyes)and 87 females(140 eyes)with an average age of(55.3±13.6)years-old(ranged from 10 to 89 years-old).The gender,age,eye type,past medical history,clinical manifestations,imaging findings and immunological indicators were recorded and statistics.Age was expressed as x±s,and independent sample t testing was used for comparison.Gender,eye type,past medical history and clinical manifestations were expressed as cases and percentage,and compared using Chi-square test or Fisher′s exact probability method.Immunological indicators were expressed as median and upper and lower quartiles or x±s,and non-parametric rank sum test was used for comparison.Results The gender rate(male/female)were 1∶2.75 and 2.9∶1,respectively in IgG4-related dacryoadenitis group and lacrimal lymphoma group.The majority of IgG4-related dacryoadenitis patients were female,while other was male;lacrimal lymphoma was more common in monocular than IgG4-related dacryoadenitis with significant difference(χ^(2)=27.047,25.486;P<0.05).In the IgG4-related dacryoadenitis group,24 cases had preoperative glucocorticoid history,accouting for 22.9%;3 cases with a history of surgery,accouting for 2.9%;4 cases with asthma,accouting for 3.8%;4 cases with lymphadenopathy,accouting for 3.8%;27 cases with sinusitis,accouting for 25.7%;and 3 cases with immune system diseases,accouting for 2.9%.In lacrimal lymphoma group,they were 9 cases,9 cases,0,0,5 cases and 0,accouting for 23.1%,23.1%,0,0,12.8%,0,respectively.The difference between groups in the history of previous s

关 键 词：免疫球蛋白4 淋巴瘤 泪腺炎 临床特征 免疫学 

分 类 号：R739.7[医药卫生—肿瘤] R777.21[医药卫生—临床医学]